Abstract:
Background: Estimately, 70–80% of cancer cases are diagnosed in late stages in Kenya with breast cancer being a
common cause of mortality among women where late diagnosis is the major ubiquitous concern. Numerous studies
have focused on epidemiological and health policy dynamics essentially underestimating the determining factors that
shape people’s choices and cues to health care service uptake. The study sought to evaluate the knowledge, attitude
and health seeking behavior towards breast cancer and its screening in a quest to explain why women present for
prognosis and treatment when symptomatic pointers are in advanced stages, impeding primary prevention strategies.
Methods: Eight focus groups (6–10 members per group) and four key informant interviews were conducted among
adult participants from rural and urban settings. Sessions were audio-recorded and transcribed. A thematic analysis of
the data was based on the concepts of the health belief model. Data analysis was conducted using NVIVO10.
Results: Most women perceived breast cancer as a fatal disease and conveyed fear of having early screening. Rural
women preferred self-prescribed medications and the use of alternative medicine for long periods before presenting for
professional care on suspicion that the lump is cancerous. Accessibility to equipped health facilities, lack of information to
establish effective follow-up treatment and low-income status were underscored as their major health seeking behavior
barriers whereas, urban women identified marital status as their main barrier. Key informant interviews revealed that
health communication programs emphasized more on communicable diseases. This could in part explain why there
is a high rate of misconception and suspicion about breast cancer among rural and urban women in the study setting.
Conclusions: Creating breast cancer awareness alongside clear guidelines on accessing screening and treatment
infrastructure is critical. It was evident, a diagnosis of breast cancer or lump brings unexpected confrontation with
mortality; fear, pain, cultural barriers, emotional and financial distress. Without clear referral channels to enable those
with suspicious lumps or early stage disease to get prompt diagnosis and treatment, then well-meaning awareness
will not necessarily contribute to reducing morbidity and mortality.